2012 New York Consolidated Laws
PBH - Public Health
Article 28 - (2800 - 2823) HOSPITALS
2816 - Statewide planning and research cooperative system.

 
    * §  2816.  Statewide planning and research cooperative system. 1. (a)
  The statewide planning and research cooperative system in the department
  is continued, as provided in and subject to this section, within amounts
  appropriated for  that  purpose.  The  system  shall  be  developed  and
  operated by the commissioner in consultation with the council, as may be
  specified by regulation of the commissioner. Any component or components
  of  the  system may be operated under a different name or names, and may
  be structured as separate systems.  In  making  regulations  under  this
  section,   subsequent   to   April   first,  two  thousand  eleven,  the
  commissioner shall consult with the superintendent of financial services
  or the head of any agency that  succeeds  the  department  of  financial
  services,  health  care  providers,  third-party health care payers, and
  advocates  representing  patients;  protect   the   confidentiality   of
  patient-identifiable  information; promote the accuracy and completeness
  of  reporting;  and   minimize   the   burden   on   institutional   and
  non-institutional  health  care  providers  and  third-party health care
  payers.
    (b) As used in this  section,  unless  the  context  clearly  requires
  otherwise:
    (i)   "Health  care"  means  any  services,  supplies,  equipment,  or
  prescription drugs referred to in subdivision two of this section.
    (ii) "Health care  provider"  includes,  in  addition  to  its  common
  meanings,  a  clinical  laboratory,  a  pharmacy,  an  entity that is an
  integrated organization of health care  providers,  and  an  accountable
  care organization of health care providers.
    (iii)  "System"  means the statewide planning and research cooperative
  system  under  this  section,  and  any  separate  system   under   this
  subdivision.
    (iv)  "Third-party health care payer" includes, but is not limited to,
  an insurer, organization or corporation licensed or  certified  pursuant
  to  article thirty-two, forty-three or forty-seven of the insurance law,
  or article forty-four of the public health law; or an entity such  as  a
  pharmacy  benefits  manager,  fiscal  administrator,  or  administrative
  services  provider  that  participates  in  the  administration   of   a
  third-party health care payer system.
    (v)  "Covered  person"  is a person covered under a third-party health
  care payer contract, agreement, or arrangement.
    2. Notwithstanding any provision of law to the  contrary,  regulations
  governing  the  system  shall  include,  but  not  be  limited  to,  the
  following:
    (a) Specification of patient, covered person, claims, and  other  data
  elements and format which shall be reported including data related to:
    (i) inpatient hospitalization data from general hospitals;
    (ii)  ambulatory  surgery  data from hospital-based ambulatory surgery
  services and all other ambulatory surgery facilities licensed under this
  article;
    (iii) emergency department data from general hospitals;
    (iv) outpatient, clinical laboratory, and prescription data, including
  but not  limited  to  data  from  or  relating  to  services,  supplies,
  equipment,  and  prescription  drugs  provided  or  ordered  by  general
  hospitals and diagnostic  and  treatment  centers  licensed  under  this
  article,  pharmacies,  clinical  laboratories,  and  other  health  care
  providers;
    (v) covered person and claims data; and
    (vi)  the  data  specified  in  this  paragraph  shall   include   the
  identification  of  patients transferred, admitted or treated subsequent
  to a medical, surgical or diagnostic procedure by a licensed health care
  professional or at a health care site or facility.

    (b) Standards to assure the protection  of  patient  privacy  in  data
  collected,  published,  released,  used and accessed under this section,
  including compliance with applicable federal law.
    (c)  Standards  for the publication, release, and use of and access to
  data reported in accordance with this  section,  including  fees  to  be
  charged.
    (d)   Provisions   requiring   specified  health  care  providers  and
  third-party health care payers  to  report  data  to  the  system,  with
  specifications  of  the  data, circumstances, format, time and method of
  reporting.
    (e) Provisions to acquire data relating to health care provided (i) to
  patients for whom there is no third-party health  care  payer  and  (ii)
  under arrangements that do not involve fee-for-service payment.
    (f) Phased-in implementation of the system.
    3.  The commissioner may provide that the system may participate in or
  cooperate with a similar system operated by, or receive information from
  or provide information to, a regional  or  national  entity  or  another
  jurisdiction,  including  making appropriate agreements and applying for
  approvals, provided that the  protections  for  health  care  providers,
  patients,  and  third-party  health  care  payers  in  this  section are
  preserved and comparable provisions are included in the other system.
    4. The commissioner may provide for access to data in the system by  a
  health  care  provider relating to a patient being treated by the health
  care provider, subject to this section and applicable state and  federal
  law.
    5.  In  operating the system, the commissioner shall consider national
  standards, including but not limited to those approved by  the  National
  Uniform  Billing  Committee (NUBC) or required under national electronic
  data interchange (EDI)  standards  for  health  care  transactions.  The
  commissioner  shall  also  consider  the  use  of  the  Statewide Health
  Information Network for New York in relation to the system.
    6. Notwithstanding any inconsistent provision of law to the  contrary,
  including  but  not  limited to section one hundred two of the executive
  law, such rules and regulations may describe data elements by  reference
  to  information  reasonably  available  to  regulated  parties,  as such
  material may be amended in the future, even though such material  cannot
  be  precisely identified to the extent that it is amended in the future;
  provided, however, that the commissioner shall  precisely  identify  and
  publish such data elements.
    7.  The commissioner may contract with one or more entities to operate
  any part of the system subject to this section.
    8. The commissioner may accept grants and enter into contracts as  may
  be necessary to provide funding for the system.
    9.  The commissioner shall publish an annual report relating to health
  care utilization, cost, quality, and safety, including  data  on  health
  disparities.
    * NB Effective until March 31, 2015
    * §  2816.  Statewide planning and research cooperative system. 1. The
  statewide planning and research cooperative system in the department  is
  continued,  as  provided  in  this  section.  The statewide planning and
  research cooperative system shall  be  developed  and  operated  by  the
  commissioner in consultation with the council, and shall be comprised of
  such data elements as may be specified by regulation.
    2.   Regulations   governing   the  statewide  planning  and  research
  cooperative system shall include, but not be limited to, the following:
    (a) Specification of patient and other data elements and format to  be
  reported including data related to:
    (i) inpatient hospitalization data from general hospitals;

    (ii)  ambulatory  surgery  data from hospital-based ambulatory surgery
  services and all other ambulatory surgery facilities licensed under this
  article;
    (iii) emergency department data from general hospitals;
    (iv)  outpatient clinic data from general hospitals and diagnostic and
  treatment centers licensed under this article, provided,  however,  that
  notwithstanding  subdivision  one  of  this section the commissioner, in
  consultation with the health care industry, is authorized to  promulgate
  or  adopt any rules or regulations necessary to implement the collection
  of data pursuant to this subparagraph; and
    (v)  the  data  specified  in  this  paragraph   shall   include   the
  identification  of  patients transferred, admitted or treated subsequent
  to a medical, surgical or diagnostic procedure by a licensed health care
  professional at a  site  or  facility  other  than  those  specified  in
  subparagraph (i), (ii), (iii) or (iv) of this paragraph.
    (b)  Standards  to  assure  the  protection of patient privacy in data
  collected and released under this section.
    (c) Standards for the publication and  release  of  data  reported  in
  accordance with this section.
    * NB Effective March 31, 2015